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Ethambutol-induced psychosis: a case report
1Department of Internal Medicine, Veterans General Hospital-Kaohsiung, Taiwan, ROC.
Zhonghua Yi Xue Za Zhi = Chinese Medical Journal; Free China Ed
|October 26, 1999
Summary
Ethambutol (EMB), an antituberculosis drug, can rarely induce psychosis. This case highlights the importance of considering EMB as a potential cause of psychiatric symptoms in patients undergoing tuberculosis treatment.
Area of Science:
- Neuroscience
- Pharmacology
- Infectious Diseases
Background:
- Tuberculosis (TB) treatment commonly involves multiple drugs.
- Psychosis is a rare but serious adverse effect of antituberculosis agents.
- Isoniazid (INH) is more frequently associated with psychosis than ethambutol (EMB).
Observation:
- A 51-year-old man with suspected TB pleurisy developed dizziness, disorientation, and hallucinations.
- Symptoms emerged seven days after initiating a regimen including INH, rifampicin, and EMB.
- Standard laboratory and imaging tests revealed no abnormalities.
Findings:
- Discontinuation of antituberculosis therapy led to symptom resolution.
- Re-challenge with EMB reproduced the psychiatric symptoms, confirming EMB as the causative agent.
- This case underscores the potential for EMB to induce psychosis.
Implications:
- Clinicians should consider ethambutol-induced psychosis in patients presenting with psychiatric symptoms during TB treatment.
- Awareness of this rare adverse effect is crucial for accurate diagnosis and management.
- Further research may elucidate the mechanisms underlying EMB-induced psychosis.